THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS


Address: 4630 South Bishop Street, Uih-mile Square Health Center At Back of The Yards, Chicago, IL 60609-3240
Phone: 7735799401

THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS (NPI# 1457523219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457523219
Entity Type Organization
Organization Name THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Other Organization Name UIH-MILE SQUARE HEALTH CENTER AT BACK OF THE YARDS
Practice Address 4630 South Bishop Street
Uih-mile Square Health Center At Back of The Yards
Chicago
IL 60609-3240
Mailing Address 1220 S. Wood Street
Uih-mile Square Health Center
Chicago
IL 60608-1202
Practice Telephone 7735799401
Practice Fax Number 3124137812
Mailing Telephone 3124131261
Mailing Fax Number 3124137812
Enumeration Date 2008-04-01
Last Update Date 2015-12-17
Authorized Official Name MR. HENRY TAYLOR (CEO)
Authorized Official Telephone 3124131261
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
IL Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IL BCBS PROVIDER 1622185 01

Other Provider/Organization Names

Other Name Type Code
UIH-Mile Square Health Center at Back of The Yards Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1427600345 The Board of Trustees of The University of Illinois Clinic/Center 6835 S Normal Blvd, Chicago, IL 60621-2535 2019-07-11
1043727571 The Board of Trustees of The University of Illinois Clinic/Center 835 S. Wolcott, Suite E-144; Mc 684, Chicago, IL 60612 2018-01-05
1871905190 The Board of Trustees of The University of Illinois Clinic/Center 840 Blackhawk Blvd, South Beloit, IL 61080-2263 2014-05-21
1841614609 The Board of Trustees of The University of Illinois Clinic/Center 3240 W Division St, Chicago, IL 60651-2405 2014-02-13
1932450160 The Board of Trustees of The University of Illinois Clinic/Center 3050 W 39th Pl, Chicago, IL 60632-2402 2012-09-27
1346596327 The Board of Trustees of The University of Illinois Clinic/Center 641 W. 63rd St, Uih-mile Square Health Center At Englewood, Chicago, IL 60621-2032 2012-07-27
1407166671 The Board of Trustees of The University of Illinois Clinic/Center 4747-51 West Cermak Rd, Uih-mile Square Health Center At Cicero, Cicero, IL 60804-2508 2010-10-20
1659501500 The Board of Trustees of The University of Illinois Durable Medical Equipment & Medical Supplies 811 S Paulina St, 118 Dent, Mc 588, Chicago, IL 60612-4353 2009-07-24
1518194364 The Board of Trustees of The University of Illinois Clinic/Center 1231 S Damen Ave, Chicago, IL 60608-1145 2009-06-19
1205022506 The Board of Trustees of The University of Illinois Clinic/Center 1110 W Belmont Ave, Ihc Thresholds Mothers Program, Chicago, IL 60657-3313 2007-09-20

Office Location

Street Address 4630 SOUTH BISHOP STREET
UIH-MILE SQUARE HEALTH CENTER AT BACK OF THE YARDS
City CHICAGO
State IL
Zip Code 60609-3240

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144843152 Healing and Fuerza Therapy LLC Clinic/Center 3735 S Wallace St 1r, Chicago, IL 60609 2020-05-26
1306407721 Athletico Ltd Physical Therapist 5336 S State St, Chicago, IL 60609 2019-06-26
1396157939 Unlimited Resources Private Vehicle 8104 S. Kingston, Chicago, IL 60609 2014-06-02
1013215474 Giles B. Mizock M.d. Ltd. Obstetrics & Gynecology 5025 W. Paulina, Methodist Hosp, Chicago, IL 60609 2011-03-09
1164691630 Alfreda D Beard Dentist 5050 So State, Chicago, IL 60609 2008-02-28
1588876510 Victor P Gutierrez Chiropractor 1824 W. 47th St., Chicago, IL 60609 2007-05-03
1619092558 Highlander Care Center, LLC Skilled Nursing Facility 4815 S Western Ave, Chicago, IL 60609 2007-03-20
1437295482 Rolando A Lara Internal Medicine 1708 W 47th St, Chicago, IL 60609 2007-01-29
1497765168 Judith H Mcdevitt Nurse Practitioner 734 W. 47th Street, Ihc South, Chicago, IL 60609 2006-08-08
1790795474 Lorrita Marie Verhey Nurse Practitioner 734 W. 47th Street South, Ihc, Chicago, IL 60609 2006-08-08
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932724390 Friend Family Health Center, Inc Clinic/Center 7355 S Jeffery Blvd, Chicago, IL 60649-3121 2020-06-11
1871117937 Primecare Community Health Inc Clinic/Center 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 2020-06-04
1407482219 Access Community Health Network Clinic/Center 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 2020-03-13
1427600345 The Board of Trustees of The University of Illinois Clinic/Center 6835 S Normal Blvd, Chicago, IL 60621-2535 2019-07-11
1114498540 Pcc Community Wellness Center Clinic/Center 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 2018-12-11
1427523125 Howard Brown Health Center Clinic/Center 3533 W North Ave Ste 1, Chicago, IL 60647-7573 2018-10-09
1336626936 Heartland International Health Center Clinic/Center 1631 W Jonquil Ter, Chicago, IL 60626-1103 2018-07-26
1760975304 Inner-city Muslim Action Network Clinic/Center 2744 W 63rd St Bldg 2, Chicago, IL 60629-2343 2018-06-08
1417473851 Howard Brown Health Center Clinic/Center 2800 N Sheridan Rd Ste 211, Chicago, IL 60657-6161 2017-08-17
1487193181 Mile Square Englewood/cook Satellite Health and Wellness Center Clinic/Center 8150 S Bishop St, Chicago, IL 60620-3854 2017-02-15
Find all providers in CHICAGO

Competitor

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City CHICAGO
Zip Code 60609

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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